Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 202002597 | NC |
N | 111NI0900X | Internist | 202002597 | NC |
Y | 207RR0500X | Rheumatology | 75418-20 | WI |
NPI | 1013394980 |
---|---|
Provider Name | Mai Abdelnabi |
First Address | Wausau, WI 54401-4129 |
Second Address | Charlotte, NC 28207-1198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013394980 | (05) | NC |
20C80 | BCBS (01) | NC |
3330793 | CIGNA (01) |